Detailed Answer
After a car collision, insurers sometimes delay or deny legitimate claims. In Pennsylvania, you can take specific steps to challenge these tactics and secure the coverage you paid for. This guide explains your rights under Pennsylvania law and outlines practical actions you can take if your insurer stalls or wrongfully denies your claim.
1. Review Your Policy and Claim File
Start by carefully reading your insurance policy, especially sections on proof of loss, loss payment, and appraisal. Compare your insurer’s stated reasons for delay or denial with the policy language. Request a complete copy of your claim file, including all correspondence, recorded statements, and internal notes.
2. Comply With Reasonable Requests Promptly
Pennsylvania law allows insurers to ask for information to verify coverage or damages. Submit documents quickly, but object in writing to any requests that seem excessive or irrelevant, citing 40 P.S. § 991.1405 (Unfair Claim Settlement Practices). Keep copies of everything you send.
3. Send a Demand Letter
If your insurer still delays or denies your claim, draft a formal demand letter. Summarize the accident, cite your policy provisions, and attach supporting evidence (repair estimates, medical bills, police report). Set a firm deadline—typically 14 days—for a substantive response.
4. File a Complaint With the Pennsylvania Insurance Department
The Pennsylvania Insurance Department (PID) enforces insurance laws and investigates bad-faith claims. You can file an online complaint at insurance.pa.gov/File-a-Complaint. Include your policy number, claim details, copies of your demand letter, and the insurer’s responses. Under 40 P.S. § 991.1501, the PID can order corrective action or penalties against the insurer.
5. Consider a Private Bad Faith Lawsuit
If the insurer continues to act in bad faith—such as unreasonably delaying payment or misrepresenting policy terms—you can file a lawsuit under Pennsylvania’s bad faith statute, 42 Pa. C.S. § 8371. A successful claim may entitle you to:
- Compensatory damages (actual losses)
- Punitive damages
- Attorney’s fees and court costs
6. Explore Appraisal or Arbitration
Many auto policies include an appraisal clause to resolve disputed damage values. Each side selects an appraiser and they jointly appoint an umpire. Their decision binds both parties. If you prefer a formal hearing, check if your policy offers arbitration and follow the required procedure.
7. Seek Professional Help
If these steps don’t yield a fair result, consult an attorney experienced in Pennsylvania insurance law. An experienced lawyer can evaluate your claim, handle negotiations, and represent you in court or arbitration.
Helpful Hints
- Document every interaction: dates, names, and details of conversations with adjusters.
- Keep a claim diary: note any losses you incur due to delays, like rental car costs.
- Request a written explanation for any denial—insurers must specify policy provisions used.
- Use certified mail for demand letters to create a clear record of delivery.
- File PID complaints quickly; the agency may impose fines or corrective orders.
- Check statute of limitations: in Pennsylvania, bad-faith actions generally must be filed within two years of denial (42 Pa. C.S. § 5524).
- Save all repair estimates, invoices, medical records, and receipts in one organized folder.
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney to discuss your specific situation.